The History of British Gynaecological Pathology

Abstract

The venerable tradition of British gynaecological pathology is honoured by brief comments on those who have pioneered work in this arena, using as the starting point the remarkable Scottish physician Dr Matthew Baillie who, with his uncles, the legendary William and John Hunter, can arguably be considered the founders of medicine in Great Britain. The impact of Baillie's great work 'The Morbid Anatomy of Some of the Most Important Parts of the Human Body' is noted. Because of the fame they achieved in working in other areas, the contributions to gynaecological pathology of Thomas Hodgkin and Richard Bright, particularly the former, are often overlooked and are noted herein as is a remarkable book on the ovary by Charles G. Ritchie, published in 1865. The middle years of the 19th century were notable because of the activities of pioneering surgeons such as Sir Spencer Wells and Lawson Tait which gradually led to a greater emphasis on pathologic examination of specimens removed at operation, as opposed to autopsy evaluation. The closing years of the 19th century and early years of the 20th century were dominated by five individuals, Alban Doran, John Bland-Sutton, Cuthbert Lockyer, Elizabeth Hurdon and John Hammond Teacher. Doran wrote an early study of tubal carcinoma and a book on that organ and the ovary. Bland-Sutton was a remarkably influential surgeon with a significant interest in pathology and also contributed a book on the ovary and fallopian tube as well as one of the early good papers on metastatic tumours to the ovary. Lockyer wrote an outstanding book on uterine fibroids and established, and funded, a museum at Charing Cross Hospital. Hurdon can be considered the first female gynaecological pathologist. She spent much of her active career in the United States working at Johns Hopkins Hospital. She co-authored a monumental book on the appendix, likely never to be equalled. Teacher worked in Glasgow for many years and was almost single-handedly responsible for the acceptance in Britain of the concepts of trophoblastic disease espoused by the German investigator Felix Marchand. Wallace Park of Dundee also contributed significantly on trophoblastic disease in later years. The years following the death of Dr Teacher were largely dominated by three individuals, Magnus Haines working in London, Claud Taylor in Birmingham, and Frederick Langley in Manchester. The first two individuals wrote an excellent textbook and Langley brought great fame to the Manchester School, ably assisted by Harold Fox, the latter being the doyen of British gynaecologic pathologists throughout the latter decades of the 20th century. With Langley he wrote an important book on ovarian tumours, an equally influential book on the placenta, and with Dr Hilary Buckley he authored a book on endometrial biopsy interpretation. Additionally, his countless entertaining and instructive lectures throughout the world represented a remarkable educational experience.